Exhibits

Click to highlight the findings that indicate the client is stable for discharge.

The client has rested well throughout the night with a continuous positive airway pressure (CPAP) device in place. Sequential devices are in place for venous thromboembolism prevention. The client ambulated 100 yards (91 meters) last night and 200 yards (183 meters) this morning.

She reports pain rating of 2 on 0 to 10 scale, located in the abdomen, described as aching. She has tolerated fluids throughout the night with no nausea or vomiting.

Assessment

Neurological Alert and oriented times 4. Cardiovascular WNL

Respiratory WNL

Gastrointestinal/Genitourinary Voided twice throughout night

A. Exercise planning:

Exercise is a cornerstone of diabetes management and can help reduce cardiovascular risk factors.
Regular activity can improve cholesterol levels, particularly by increasing HDL (good cholesterol) and potentially lowering LDL (bad cholesterol).
It can also aid in weight management, which is particularly important for this client with a BMI of 28 kg/m^2.
B. Oral antidiabetic:
While oral antidiabetics are a common treatment, the client's laboratory results do not indicate a current diagnosis of diabetes, thus it may not be necessary at this stage.
C. Short acting insulin:
Short acting insulin is typically used for managing blood sugar levels in individuals with diagnosed diabetes, particularly type 1 or advanced type 2 diabetes.
There is no indication from the client's history or lab results that he requires insulin therapy at this time.
D. Extra carbohydrates:
Adding extra carbohydrates without monitoring blood glucose levels could be detrimental, especially in individuals at risk of developing diabetes.
Carbohydrates need to be carefully balanced in a diabetic diet, and the client has not been diagnosed with diabetes.
E. Nutrition education:
Education on nutrition can help the client make informed food choices to manage both blood sugar and cholesterol levels.
It can also provide guidance on portion control, which can contribute to weight management.

F. Weight reduction treatment:
Given the client's overweight status, a weight reduction plan could help lower the risk of developing diabetes.
Weight loss can also have a positive impact on cholesterol levels and overall metabolic health.
G Long acting insulin:
Long acting insulin is used to manage blood sugar levels throughout the day and is typically prescribed for individuals with diagnosed diabetes.
As with short acting insulin, there is no current indication for insulin therapy for this client.

A. Frequent premature ventricular contractions: While abnormal heart rhythms are a concern, they may not warrant immediate intervention in this context unless they are causing significant hemodynamic instability.
B. Paroxysmal supraventricular tachycardia: This cardiac dysrhythmia may require intervention but is not directly related to the administration of alteplase.
C. Lower extremity edema: Lower extremity edema may indicate venous insufficiency or other underlying conditions but is not directly related to the administration of alteplase.
D. Headache with blurred vision: This could be indicative of worsening cerebral edema or increased intracranial pressure, which are potential complications of alteplase administration and require immediate intervention.